Channel 4 FactCheck goes behind the spin to dig out the truth and separate political fact from fiction.

“Most counselling is offered by the big abortion providers themselves, like the British Pregnancy Advisory Service or the Marie Stopes clinics, which are paid millions by the NHS to carry out terminations – and so profit from the process.”

“…I am proposing an amendment to the Health Bill currently going through Parliament, which would require women to be offered independent counselling. This won’t be offered by any religion-affiliated groups, but by the British Association for Counselling and Psychotherapy…”Nadine Dorries MP, 31 August 2011

The background

The ever-emotive subject of abortion is set to stay in the headlines in the coming weeks as MPs prepare for a free vote on an amendment to the already controversial Health and Social Care Bill.

The Conservative MP Nadine Dorries has proposed altering the legislation to stop charities who carry out abortions also providing counselling for women considering a termination.

She says there’s a conflict of interest which means the advice the organisations give to pregnant women cannot really be impartial. Her campaign is being supported by the Labour backbencher Frank Field.

The temperature of the debate is already high, with Ms Dorries vowing to defy “pro-abortion zealots” and the head of the Royal College of Practitioners, Dr Clare Gerada, warning that the move “will simply reverse the advances of the past 25 years”.

The analysis

In an article published in the Daily Mail on Wednesday, the Tory MP writes that the British Pregnancy Advisory Service (BPAS) and Marie Stopes “are paid millions by the NHS to carry out terminations – and so profit from the process”.

BPAS and Marie Stopes also offer “most counselling” to women, Ms Dorries writes, after pointing out that “doctors of pregnancy advisory services have no duty to offer professional, impartial help to women considering an abortion”.

Is there a conflict of interest?

Both organisations make no secret of the fact that they do perform thousands of abortions every year, and are indeed paid to do so by the NHS.

But they take issue with the use of the word “profit”. In fact, both are not-for-profit registered charities.

BPAS say: “Any small surplus that we make is ploughed back into providing services.”

Whether the existence of a large amount of revenue, as opposed to profit, is still evidence of a vested financial interest is of course a broader question.

Both charities vehemently deny that they push women into having abortions.

BPAS Chief Executive Ann Furedi said: “Our staff are healthcare professionals – doctors and nurses committed to treating the women in their care – and it is an insult to imply that they would push women into treatment they did not want.”

Maries Stopes said: “There are no targets or incentives for counsellors to promote abortion as an option above any other. On average, 20-25 per cent of women that speak to one of our counsellors choose to continue with their pregnancy.

“If we felt that a woman was not completely sure of her decision we would suggest that she speak with a counsellor.”

They also say that there is no evidence for Ms Dorries’ assertion that “the abortion system and process is abusing women” and have challenged her to provide evidence that the current system arrangements are not working.

What is Ms Dorries proposing?

The amendment to the Bill currently going through Parliament proposes that it will be the responsibility of GP consortia to commission “independent information, advice and counselling services for women requesting termination of pregnancy to the extent that the consortium considers they will choose to use them”.

The next part of the amendment clarifies that “information, advice and counselling is independent where it is provided by either — (i)a private body that does not itself provide for the termination of pregnancies; or (ii) a statutory body.”

So despite Ms Dorries’ claim in the Daily Mail that counselling “won’t be offered by any religion-affiliated groups, but by the British Association for Counselling and Psychotherapy”, there is nothing in her amendment to guarantee that.

Instead, the legal position would be that only Marie Stopes and BPAS would be prevented from offering counselling, and there would be no statutory reason why, say, a fundamentalist Christian group could not bid for a contract with an NHS consortium.

There is also nothing in the proposed amendment to back up her assertion that the British Association for Counselling and Psychotherapy (BACP) watchdog will be providing counsellors – or even that a “private body” would have to be a member of the organisation.

A BACP spokesman said: “Ms Dorries says that BACP will be supplying the counselling if her amendment becomes law. But BACP is not a therapy supply company but a members’ organisation offering self-regulation in an otherwise unregulated world.

“I can only guess that she means those doing the counselling will be BACP Members. But BPAS already employs BACP members!”

BPAS clarified that, while it’s not compulsory, many of the counsellors it uses are members of the association and have signed up to its code of ethics, a regulatory mechanism and a complaints procedure.

Marie Stopes said: “The counsellors that we work with are all members of BACP and receive regular supervision and training from them.”

So if the amendment became law it would appear that, rather than BACP taking a leading role in the provision of therapy, the chances of an abortion counsellor being a member of the professional body would be smaller than it is now.

The psychological effects of abortion?

In her Mail piece, Ms Dorries also refers to a study published in the British Journal of Psychiatry, which “revealed that women who have an abortion are three times more likely to develop a drug or alcohol addiction and 30 per cent more likely to have mental disorders compared with other women”.

The paper in question looked at the mental health of 117 women in New Zealand who had had abortions. The researchers concluded: “The evidence is consistent with the view that abortion may be associated with a small increase in risk of mental disorders.”

They went on to say: “The results do not support strong pro-life positions that claim that abortion has large and devastating effects on the mental health of women. Neither do the results support any strong pro-choice positions that imply that abortion is without any mental health effects.

“In general, the results lead to a middle-of-the-road position that, for some women, abortion is likely to be a stressful and traumatic life event which places those exposed to it at a modestly increased risk of a range of common mental health problems.”

Also in 2008, a review of existing studies by the American Psychological Association found that “the prevalence of mental health problems observed among women in the United States who had a single, legal, first-trimester abortion for nontherapeutic reasons was consistent with normative rates of comparable mental health problems in the general population of women in the United States”.

In the same year, the Royal College of Psychiatrists issued a statement saying: “The current research evidence base is inconclusive—some studies indicate no evidence of harm, whilst other studies identify a range of mental disorders following abortion.”

The college is expected to publish a final report on the existing medical literature in the autumn.

The verdict

While FactCheck doesn’t propose to weigh in to the wider debate on the rights and wrongs of abortion, we are going to take Nadine Dorries to task on some of the points she makes in her article.

Her claim that the leading abortion providers “profit” from their work is misleading.

More importantly, the promise that religious groups won’t be involved in abortion counselling doesn’t square with the detail of what the MP is actually proposing.

And it’s not helpful to quote selectively from one study in an effort to show that the existing scientific literature backs the claim that “the abortion system and process is abusing women”.

Comments

Steph
31-Aug-11at

As a pro-choice woman living in Ireland I’d strongly advise those with an influence on their MP to ask that they vote against this. In Ireland advice about seeking abortion abroad (usually in the UK) can only be given in one to one counselling sessions, meaning no website can give information on it. Pregnancy advice services are set up by religious organisations all over the place and they frequently claim to be given non-biased counselling but will in fact try to dissuade a woman from having a termination. Sometimes these people have no medical backround whatsoever, sometimes they have it but choose (with little or no consequences) to ignore the professional ethics that state they must give their patient all they need to make an informed decision. It sounds to me like the laws you have at the moment are the kind of laws Ireland should be implementing, not the kind the UK should be ammending.

A laudable attempt to inject some reason into this discussion. Dorries gets given far too much opportunity to voice her OPINIONS in mass media and much of the media do little to assess whether her claims have any basis in fact. Her wilful ignorance (to give her benefit of the doubt) is dangerous to women and the fact our parliamentary process allows this sort of evidence-free twaddle to go to a vote shames us all

Is it right, from the amendment, that they wouldn’t be allowed to offer advice? Doesn’t it just say that women must be offered independent advice? Surely the woman could ask to have advice from the abortion agency if she wanted? I doubt they are making that illegal? Just it couldn’t be referred to as independent?

Also, the word ‘profit’ is interesting. Is she potentially using it in the sense of ‘benefit from’ rather than about making a financial profit. Either way, she has clearly used confusing language. intentional or not. There is no doubt though that if they are employing people and that is dependent on receive funding then they may have an incentive to push abortions. Of course, that doesn’t mean they actually do.

Finally, please could you do a fact check on the claims being made by pro-choice groups? Particularly when they say that this is just going to mean that only religious pro-life groups will get to give advice. Patently it’s not true – any group of any opinion could set up a group. But they seem to want to use scare tactics to prevent the bill, rather than question the actual content of the amendment.

MPs are meant to be in Parliament to represent the public; to act as their delegates. They govern on our behalf, in our interest and paid for by us; at least they are meant to. However what seems to increasingly be happening is that MPs are using the Parliamentary process to pursue their own interests, their own ideology. They behave as though we have given them a 5 year dictatorship during which they can pursue their personal agenda. This attitude (as shown in this article about Nadine Dorries is an excellent example of this. Politicians pursuing their own private interests and ideology at public expense to public detriment is bringing the entire political and governmental process into disrepute. Politicians might find it convenient to disregard the public but they have all but destroyed any respect people have for the process of government.

This is such an emotive topic. I spoke to BPAS about my termination. They were understanding and incredibly kind at what was a very difficult time for me. I did not have my abortion with the “100% certainty” that is suggested “most women” have upon entering into this process. I knew it was the most sensible option for me, the children I already have and the baby I had accidentally conceived. I was unable to use the BPAS service unless I paid, due to “catchment” issues. I’m not sure how this works. The NHS service I had to use was awful. We were like cattle. Emotional counselling? I read a leaflet. It is the single most traumatic experience I will ever have, but not having our baby was the right thing to do. I did, however, need someone to talk to. That service was absolutely not available. Things need to change. Drastically. Abortion is bloody awful, but thank God we have the option to do it safely. Impartial and empathic counselling before and after is a must IF the woman and/or her partner if there is one, wants it. This is not a black/white issue. Every conception deserves to be recognised for its individual circumstances. Why is that so hard for so many people to see?

(Being a bloke I cannot comment from the same perspective but), I would imagine that at such a difficult time what is needed are facts presented in an un-biased way together with understanding. I cannot imagine that having religious dogma poured out without regard to your circumstances and situation is going to help; in fact I would expect that it would make things harder. I am quite sure the current systems are not perfect but I would suspect being told “you will go to hell”, ” your child was a child the instant you conceived and termination is murder”, etc. is unlikely to help anybody at such a difficult time.

I would expect religious people would seek advice from their existing religious infrastructure. For others, to push religious based dogma into them at such a difficult time is beyond unhelpful.

I don’t believe that there is a conflict of interest. In my experience most women who turn up at an appointment with BPAS (and probably Marie Stopes too) have already made up their minds that they wish for a termination. It is therefore the responsibility of BPAS to counsel the applicant and explain the alternatives available for that person. I don’t understand why Ms Dorries considers that BPAS counsels women into having abortions, when the evidence is quite to the contrary.

Surely fact Marie Stopes etc are not-for-profit is irrelevant…they still have a vested interest because their staff will lose jobs, chief executives on 6 figure salaries will be paid less, if number of abortions falls. We don’t let state schools mark their own GCSE exams even though they don’t make a profit, and in that case having external examiners and regulation does not imply we think teachers are evil cheats. You just want to avoid conflicts of interest.

.. what confuses me most is that the same argument would be just as valid (or invalid) for the whole of healthcare! That means that for any advice you ever get from a doctor, you should also get advice from an independent non-doctor, non-healthcare professional, who might not know what they are talking about, but who would be ‘independent’ from the healthcare system.

“Profit” may be the wrong word, but if your employment would cease if abortions stopped (as is true of employees of Marie Stopes and BPAS), then you clearly have a vested interest in the number of abortions being maintained. Of course they will claim they are independent. “It is difficult to get a man to understand something, when his salary depends upon his not understanding it!” — Upton Sinclair.

The comparison with other doctors in general is not apt because abortion is an elective procedure, not treatment for an illness.

Daniel – you do realise Marie Stopes and BPAS are charities? So anyone can go and download their accounts from the Charity Commission? (go and take a look – they’re quite detailed)

And that they’re companies registered as nonprofits, so the taxman would take a dim view if Dorries’ allegations were grounded in reality?

In short, you either believe factcheck, the Charity Commission, HM Revenue & Customs, and the auditors of the accounts, or you believe a person whose constituency blog was, in her own words, “70% fiction”

If there’s one thing I’ve learnt, it’s that “wanting” something isn’t enough of a reason to have it.There’s a huge difference between knowing you need to have an abortion and wanting an abortion.There’s a huge difference between wanting a baby and having one.I didn’t want my abortion,but I knew it was what I had to do to protect my three children,my partner’s two children,his life and mine.In basic terms,I sacrificed one life to save seven others.I had no difficulty gaining access to an abortion. Good. Don’t force me to explain my decision about my my life and the lives of those most important to me…including the life I was so aware was growing inside me.I knew what I had to do.I needed someone to tell me the mixed up feelings of pain, guilt, relief, terror, anger and resentment were ok.How dare Nadine Dorries (self-declared conduit of God) preach otherwise? She cites the fact that England is the “abortion capital of Europe” as reason to make it more difficult to gain access to one? What? Perhaps there’s a deeper issue that needs addressing here?Or maybe she enjoys the thought of a society filled with even more people scarred by a life of knowing they were…

It’s no surprise if abortion takes its toll on mental health. The proper comparison isn’t with “other women”, it’s with the same women forced to go through with an unwanted pregnancy (or in Dorries’ world, an illegal abortion). It’s almost impossible to know for sure, and either way gives nobody the right to interfere in this difficult decision.